Consumers, providers and health care purchasers need high quality information to help them compare and evaluate their health care options. The proposed CAHPS IV project will advance the AHRQ CAHPS mission of improving health care by ongoing measurement and reporting of patients' experiences with care. We propose a 5-year effort to conduct quality improvement (QI) studies based on CAHPS data, enhance reporting guidelines and update existing reporting resources, extend the science of reporting, facilitate use of existing CAHPS survey, develop new surveys, evaluate new data collection methods, and promote the use of CAHPS products. Specifically, we will perform a systematic literature review and environmental scan focusing on how organizations learn to conduct effective QI using CAHPS surveys, an initial QI study of early, middle and late adopters of the patient-centered medical home (PCMH) model of care in a northern California preferred provider network, a final QI study of accountable care organizations, a pilot of a national learning network for organizations engaged in QI using CAHPS, cognitive interviews to evaluate composite labels for the CAHPS PCMH survey, an experiment evaluating innovative reporting techniques that involve combinations of standard CAHPS data with patient anecdotes about care, evaluation of the benefits and costs of including CAHPS roll- up scores in comparative quality reports, development of a Your CAHPS Survey tool to help users compile surveys tailored to their specific needs, and data collection (e.g., web versus interactive voice response) experiments. In addition, we will update the CAHPS Improvement Guide, TalkingQuality website and the Report Card Compendium, develop and evaluate a Spanish language report for the CAHPS PCMH survey, maintain existing survey tools and prepare OMB and NQF applications for CAHPS surveys, and advance analytic methods for CAHPS data. The project team is well suited to achieving the study objectives given its prior accomplishments and established working relationships. The work is innovative because it will yield important new information about how to improve health care using CAHPS data, improve reporting of quality information to consumers, facilitate use of existing CAHPS surveys by creating an interactive database and search engine, improve participation rates in CAHPS surveys by translating into the third most common language in the United States, and provide information about the comparability of data collected using existing and newer modes of data collection.